Abstract
Objective: To verify the effects of preventive measures against mother-to-child transmissions (MTCT) of HIV in infants born to HIV-positive females to investigate the effects of exposure to antiviral drugs in non-infected infants and to investigate the pathological conditions and diagnoses of infected children.
Method: Over an eight-year period, we conducted a questionnaire survey at hospital pediatric departments throughout Japan. In the primary survey, we asked whether respondent institutions had any experience diagnosing infants born to HIV-positive females, and a detailed secondary survey was then carried out at institutions with such experience.In addition, follow-up surveys were conducted regarding non-infected infants in 2004 and infected children in 2005.
Results: The number of known infants born to HIV-positive females was 287 as of 2006, and MTCT was observed in 42 cases. The rate of MTCT decreased to 0.6% due to thorough preventive measures (including antiviral drug treatments on mothers and infants, cesarean deliveries, and the termination of breast-feeding). In many non-infected infants, anemia was observed in the neonatal period. The 42 infected children exhibited no symptoms in23 cases, moderate disease in 1 case, AIDS in 3 cases, death in 11 cases, and unknown outcomes in 4 cases. Among the 26 cases that were 4 years old or older, highly active antiretroviral therapy was performed in 22 cases.
Conclusion: Due to the preventive measures against MTCT, the rate of mother-to-child transmissions of HIV is now approaching 0%. It is important to implement HIV antibody tests on 100% of all pregnant women. However, the issue regarding side effects in infants remains unclear, therefore further study is required to clarify whether the current preventive measures against MTCT are appropriate. In long-term infected children, the implementation of highly active antiretroviral therapy is becoming more common and the number of stabilized cases is increasing.
